In this episode, we sat down with Dr. Pavel Krastev to discuss his recently published book, “The Power of DR” that describes how we can bridge the gap between medicine and dentistry for the betterment of overall health.
Watch this video to learn the following:
- What it’s like to manage a small boutique practice during a pandemic
- COVID-19 has created a lot of loneliness for people – we need to network virtually
- How the dental industry can bridge the gap between medicine and dentistry to unite as healthcare
Rolando Mia, from Zyris, is the host of our series, Dental Voice. In this show, we focus on the latest news, topics, and conversations happening in dentistry and assess differing views across the nation. In Season 2, we’re focused on, “What’s Working and What’s Not”, where we’re debunking myths by assessing trial and error since the start of Covid-19.
Rolando Mia: Hello, everybody. Welcome to Dental Voice with Zyris Season Two. Thank you for joining us. My name is Rolando Mia. The purpose of Dental Voice is to meet professionals in dentistry and understand their perspective, their insights, their opinions, and also get their advice regarding some of the things that we’re experiencing today. So, our guest today is Dr. Pavel Krastev.
Dr. Pavel graduated from the New York University College of dentistry. He taught there as an assistant professor after he graduated for a couple of years. And then he spent two years basically training in the department continuing education for implants. In addition, one of the things that’s really cool is in conjunction with Dr. Nguyen, Dr. Krastev has written a book, “The Power of DR”, which I think is going to be kind of cool because in in understanding the context of that, there’s a whole bunch of things that I think are so appropriate and so powerful for COVID and what we’re dealing today. Hello, Dr. Pavel, how the heck are you? And thank you for joining.
Dr. Pavel Krastev: Hello, Rolando. It’s a pleasure to be here.
Rolando Mia: So, I want to understand, first of all with regard to dentistry, because you know, you work in a practice and you share with me. Could you just give a context of what your practice looks like, how it’s connected to kind of the community, all that type of stuff and what you all do?
Going from a Large Dental Practice to Boutique Size
Dr. Pavel Krastev: Sure. Well, I guess I’ll start from the beginning. I’ll roll the tape back quite a few years. So, I graduated school in 1993 and then I started, you know we have an option when we graduate school, we buy a practice, sell a practice. What are we, you know, there’s a million options.
So, I chose to start from scratch. And it was very difficult. So, I started with a very small office. And then gradually, you know I think I spent the first 10 years of my life sort of being locked in my little box and being isolated from the world. And just did dentistry went home, did dentistry, went home.
Then about 10 years into my practice I joined NYU at the prestigious two-three year continuing education implant program, which was designed for licensed dentists to train in implantology and reconstruction. So, I did that from 2002 to 2004. And then I was fortunate enough to have the team invite me to stay on and teach. So, I was there for about 14 years teaching implant surgery. At the same time, I had the opportunity to work with two friends and colleagues.
We opened the state-of-the-art office; I believe seven or eight operatories. You know, really one of the finest offices I’ve seen. So, I was there for about three years, and that didn’t work out for me. So, the big, it was choking financially. It was very difficult, very stressful.
And then I met my wife, my current wife. And at that time, as I left that practice, I joined the team of my in-laws. Now my in-laws are both internists. My wife comes from a family of doctors, her brother’s a doctor, her mother’s a doctor, her father’s a doctor. Her aunt’s a doctor, they’re all doctors. A lot of competition, a lot of step up. So, when I got out of this big office in this big venture, which as I said, unfortunately didn’t work out for me. Then my in-laws said, “Well why don’t you just put your practice into our facility?” And that was the best thing I ever did.
So, right now I have a very small practice. It’s a boutique practice. I don’t see a thousand patients a week. We probably see five to six patients a day and provide very high-quality care. We know all patients side, I’m the one who does absolutely everything.
There are normally five doctors, 10 doctors running around. And the advantage is that anytime there’s a compromised patient I have someone to run to and ask questions. And it’s really very effective. Aside from we gain gaining a lot of referrals from the practice. So, we work as a team. My in-laws have a very good reputation. They’re very well looked upon. So, you know, life is good.
Rolando Mia: So, I love the fact that you had the opportunity to experience a much larger practice and you chose to be in your personal practice. And now you’re doing that. I’m very curious, because in speaking with other clinicians, COVID has been a very big impact because they are dealing with the, I’m going to call it the apprehension and the anxiety of the team with regard to exposure. If I understand correctly in your practice you don’t have to do that. What effect has COVID had in everything that you’re currently doing right now?
The COVID-19 Monster’s Impact on Dentistry
Dr. Pavel Krastev: Sure. Well, look, initially…first, let me say this. COVID is a, and I’ve said this in many interviews, and in some of the partners that we do with Global Summits, you know, and I always mentioned this when hit, I thought it’s going to be a two-week vacation. You know, I figured it will take a week, two weeks off and then it’s all going to settle down.
But this monster, unfortunately, it’s not a static event, which I always say when you have a static event the world can start healing the next day. The other thing is most of us, when there is something going on in the world, we have a tendency to look from a faraway place and say, “Well, this is going on there. It’s unfortunate, but it’s not really affecting us.” So, the COVID monster as I call it, it hit the whole globe. It hit all of us. It hit everyone in every profession, in every walk of life, children, adults, young people, old people. And I want to salute all the professions, all the healthcare workers out there. You know, we all came together.
I didn’t see too much complaining going on. We obviously were all scared. I mean, the anxiety level is tremendous. Of course, now we were shut down for three and a half months in New York. And as most of you know, New York got hit, really, we got slammed with some of the highest numbers as far as I know in the world, relatively speaking. And I think that has to do with the fact that New York city is a very condensed population.
So, the more condensed you are, the bigger buildings you have with elevators going up and down all day, it makes things that much more difficult for us to fight the disease and contain the disease. No matter the social distancing, no matter the mask wearing which I highly recommend them. And I certainly wear a mask everywhere I go. I don’t think we should be forced to do anything that we don’t want to do as human beings, but you know, we have to pitch in all of us and do the right thing to protect ourselves and each other.
So, in my office, we went back to work, I have to be honest, the anxiety level was horrendous. Because, you know as we know this thing doesn’t discriminate. It doesn’t matter what color you are. It doesn’t matter where you come from. It gets you gets you. And I certainly know quite a few people that have passed away from the disease. I know several people that have had it three times, and that’s scary.
So, patients wise, some patients needless to say experienced the same anxiety that we experienced as healthcare professionals. But some patients are more at ease with it, but certainly we have the PPE. We have the workflow is compromised because we’re seeing less patients intentionally. Because we’re taking aside from the standard PPE protection and all these operating protocols, and everything that we do normally, now we’re on steroids. So, we’re doing everything more intensely. We’re seeing less patients. We’re screening everybody when they walk in, when they…you know, it’s a battle that all of us healthcare professionals fight together.
But look, we’re managing. We’re managing, we’re…you know one thing I must mention, it’s a very lonely time. And there were Global Summits with Dr. Kianor Shah. You know, I mean Kianor Shah is a gentleman, and a scholar, and he’s a futuristic person that sees really the future. And with Global Summits, we pivoted right away into let’s bring everything at home.
So aside from before, we used to travel to courses and this and that, and it was great. You get to see new places; you get to fly in airplanes. And I love flying airplanes. I love airplanes. I can fly all day. But the thing is these things changed in Global Summits. And we all came together sharing knowledge. Global Summits a peer-to-peer doctor to doctor platform that is decentralized. So, there’s not a single godfather sitting on the top calling the shots. We’re all together as a team across the world, and we’re all sharing knowledge and having fun.
I’m very excited to say that now in the end of November, we have a two-day event with live courses. There’s going to be a… It’s going to be a grand event. There’s going to be award ceremonies live. And we’re going to have a certain manufacturer’s, certain companies doing live presentations of their products. So, we’re very excited. It’s coming up shortly. And aside from that, we have now the, all the top hundred doctors’ rewards are being now nominated and submitted. So that’s coming up next. So, we have a lot of stuff going on.
Rolando Mia: That’s… First of all, I apologize. I meant to mention that you’re also a member of the Global Summit.
It’s interesting. The comment you made about, “We used to get together. We used to spend a lot of time; you know face-to-face. “Now everything is being done this way. And the context around the Global Summit as well as the way we’re engaging with each other has completely changed. How has that affected your practice? And are you in doing things like teledentistry right now? How do you see that affecting just dentistry overall?
The Growth of Teledentistry in 2020
Dr. Pavel Krastev: Well, again, as I said, we have a very small practice. We have a boutique practice, so our volume didn’t change. So, I didn’t feel so much of the change in my personal practice, in our practice. But look the guys and ladies, and who had these big practices with multiple chairs, with the biggest staff, for them I think they paid more of a price because of the scale of their operation. So, we didn’t have that problem. But traveling as I said was always great.
So, when we locked down, I think the loneliness factor kind of sets in after a while. And you start to feel a little bit isolated from society, you can’t really go on with your regular daily activities and it’s difficult. But when you realize that you have all your colleagues, and see I think in dentistry and in healthcare, I think in all professions, sometimes people are afraid to speak their minds. They are hesitant to open up.
So, when we unite with all colleagues together, we realize that this is actually, you know it’s difficult of a time as it is. We realize that we’re not alone. We realized that what I’m experiencing, you’re experiencing, and the next guy next door is experiencing. And when we start sharing our passions and our problems, you know, it makes the pain of going through this global catastrophe, much easier, I think.
Rolando Mia: Are you finding that in the COVID or the post COVID environment, you’re actually talking to more people than you were prior to this, when it was about travel, but now you can literally pick up and just get connected with people or is that changed?
Dr. Pavel Krastev: Well, absolutely. And, you know, you asked about teledentistry. And one thing I want to mention, I mean I think teledentistry and telemedicine is probably the future in many aspects and I’m all for it and all behind it. But the problem, one problem with teledentistry or tele-anything, doing anything, there’s certain professions that allow you the luxury of working from home and not much change.
But when you’re in healthcare, for example if you’re a cardiologist and you know, I mean, sure you can do certain things online. The other example, my in-laws are internists. So as internists, they do tell it then telemedicine a lot more successfully than I can do it. Because unless I go into the oral cavity and do what I need to do, it’s really, we’re limited with how much we can do.
So, do I spend more time now online? Yes. Definitely we’re doing more work with computers and colleagues, you know. And, you know life changes things change. We need to adapt to these things. The younger colleagues coming out of school now obviously face a rather big challenge.
These kids are coming out with huge loans. They have to start working, practicing to pay off their loans. Then they have the other issue they face, to start a practice or to buy a practice, you know. So, it’s very difficult. And I encourage all the young guys out there. You know, one thing that I did too late in my life, I started networking.
Networking is very important guys. You have to network with the correct people. And I underline in highlighter, in red and blue, in any color you want, network with the proper people. Because every once in a while, you may come across some individual or organization that maybe you should stay away from. Having said that, you know it’s a different life, but we’re managing. And you know, we got to take it. They might die and be strong and do the right thing and then we get over it. We have to think positive.
Rolando Mia: I love the context around that. And yes, I agree. Connections are important, the right connections. Let me ask this before we get off, when you look at what’s happening in COVID we’re seeing a second round of craziness. How do you see that affecting?
Because prior to this dentistry was considered non-essential and you know, don’t go to the dentist because you know, he’s going to be the maker for an infection. And according to the ADA, very few cases of COVID come out of the dental practice. So that makes you feel good because the infection control protocols are working. But now you have an increase. How do you see that effecting dentistry?
The Importance of Networking in Your Dental Community
Dr. Pavel Krastev: Well, I’ll tell you and I can speak for, I live in the Western part of Long Island. So, we’re about half an hour by train from New York city. There are definitely some hotspots in New York happening in Brooklyn and in Manhattan and in Queens, as I understand. So, there was no… we’re not being forced to not work or anything, but certain schools have been closing it. They’re trying to handle it in more localized aspects.
How do I see it? I mean, look, I pray every day that this thing will eventually give up on all of us and just disappear. My brother-in-law is a critical care pulmonologist in one of the major hospitals. And he… I speak to him on a weekly basis, and he’s updated me that after the big wave came and then went down, we weren’t seeing too many COVID patients. Now it’s on the rise again. It’s definitely not as intense as it was the first time around, but certainly there is there is hotspots, and you know it’s playing up and down.
So, it’s…again, what choice do we have? We have to think positive. We have to protect ourselves and our patients. As far as I know, 1% of the dentists have been catching the disease. So, we’re doing very well I think in terms of how many people have it and didn’t get it. But you know, Rolando every time I go to work, every morning I wake up, in the back of my head, I say to myself, “You know today may be the day I get it. Today maybe the day somebody else gets.” You know, and it’s scary. I mean, I look at my children, you know.
My kids were home for months and months and months. And I mean, kids as you know, they like to sit and play on their iPhones all day and that’s great. But after a while they miss their friends, they miss their routine, their education it’s changing. In a way it affected every profession, every age group. It’s a tough thing to deal with. But we have no choice. What can we do?
Rolando Mia: Yeah. So, I had an opportunity to kind of have a quick view, but in conjunction with the book you wrote, “The Power of DR”, I’m curious, because in it, you speak about the, or the context about the profession and the energy, and making sure that you’re driving share. Share it if you would just a little context around that, and you know for people in the event that they want to read your book or check it out. What’s kind of the underlying sentiment behind it?
What is the ‘Power of DR’?
Dr. Pavel Krastev: The idea of the book was to…when we say, “Power of DR”, we’re not claiming that we have the superhuman power, that’s better than you, or you’re better than the next guy. It’s not what it’s about. It’s about the fact that as doctors, we spend many years training, we get the lab coats, and we get the title. And with that title comes a thing of nobility, a thing of treating patients, a thing of trying to do your best for your patients. So, it’s a peer-to-peer concept.
In the book, doctors from different spheres express where they come from, they open up and talk about themselves and what inspired them to get over certain challenges in their lives. We openly share some of our thoughts. We share how we came together as a profession, and what our responsibility we have as doctors in all of healthcare to carry the torch forward, so to speak. So, everyone has a story. I have a story, I’m sure you have a story. Well, actually you don’t because you know, you’re perfect. But we all have a story.
Sometimes, you know, I think before I met Dr. Bak, and I met Dr. Bak with Kianor Shah. So, what happened was one thing led to another. We all started networking very quickly and we started putting some paper together. And I mean, I tell you I never imagined I would write a book. And here’s why. What do I know about writing books? What do I know about publishing books? Nothing.
But with the proper networking we came together, we met, we spoke, and then one thing led to another very fast and it happened. So, “The Power of DR” is an inspirational book, I think, to many. So many docs will realize that they’re not the only ones who feel a certain way. And we encourage people to be open, you know, talk about with your colleagues and with your peers, you know about what’s going on in the world, what you feel, what you want to change. It’s okay to open up. And people don’t have to be so shy. I’m a shy guy.
It takes courage to open up. And once you open up, you almost feel like something is lifted off your chest that you’re talking and sharing your experiences. We’re a big family. Doctors in the dental industry, and the medical industry, we’re one big family.
So, the question now becomes, how do we bridge medicine and dentistry to come closer together? And when I say medicine and dentistry, I don’t mean just medicine. I mean, optometry, I mean chiropractic’s, I mean nursing. You know, healthcare. Let’s look at it in a bigger scale. Healthcare is one big family, and we have to work together, not against each other. You know?
So, this book Dr. Bak was, and I thank him publicly. And I’m very grateful that he walked us through the steps, and he works… Dr. Bak was very fast. He was very quickly. And I mean quickly, the guy’s been some serious world records in writing so many books in such a short period of time.
Hopefully we’ll write some more books together. You know? The thing that I want to drive across is this, we strongly with Dr. Shah believe in the D to D, we call it the D-to-D concept. So, “doctor to doctor” concept. Doctor to doctor concept is all about bonding together and uniting and working together, right?
Rolando Mia: That is awesome. I mean, that is… You know, we had a guest, and you know Stanley Bergman mentioned that the role of the clinician, the doctor is more, more important than ever, with regard to not only connecting, but also educating, communicating and who else to talk to people about the experience that they had. It requires, you said the word courage.
But there’s also this context of taking on a leadership role to be a, to kind of stand up, get up and basically say, “Hold on a second. I know something here. Let me communicate that.”
What advice would you give people to kind get past that? Because not every doctor is willing, or I’m going to say that everyone is willing, but doesn’t have the courage or the ability to vocalize, verbalize or communicate as effectively. It’s one of the biggest issues that doctors were facing in the dental practice. Because it’s hard to talk to people. So, what advice would you give people to overcome that?
Healthcare is One Big Family
Dr. Pavel Krastev: Well, as I said, I think we all have different personalities. Some of us are shyer than others. Obviously public speaking is not for everyone. I mean, there’s always, I think an anxiety level when you do these shows, when you talk in front of thousands of people and many are listening. So, I encourage, for young professionals out there, come out of the shell. Do a lot of continuing education. Socialize with your colleagues. And as I said, don’t be afraid to open up. Because what’s the worst thing that can happen?
There’s always one or two people here and there they’ll make fun of you, they’ll mock you, but it’s okay. We’re bigger than that. We’re bigger than that. We’re not going to pay attention to the small minds. You know, we’re going to pay attention to the big picture. And the big picture is medicine and healthcare,
We’re one big family. We must support each other. We must back each other up. And we must not look at each other as competitors. Because you know, Rolando and I want to mention this in my practice when I see work that’s maybe not as good as it should be, or maybe a little bit inferior to what, you know what I would have done perhaps. Not that I’m perfect. I make plenty of mistakes.
You know, not everything I know works, but I’m very cautious not to criticize other colleagues. And I’ve been like this my whole life. And I don’t like to steal or try to steal patients from other doctors. It’s not my style. If an emergency comes into my office from the guy next door which happens, I send the patient right back.
Now is most of us dentists know when you get an emergency, and the patient feels comfortable. Very often, the patient will say, “Well, doc I want to stay with you.” Then I ask him, I say, “Well you have your dentist next door. You got to go back.” So that’s the way I operate.
So, I don’t like to make colleagues look bad. I don’t like to have bad blood amongst colleagues. And I think that the idea of competition, we should eliminate, you know. There’s plenty of food to go around for everybody. All right?
I think when you can reach out to the dentist next door, when you need something, you know it’s a better, it’s a warmer relationship. And I highly promote that, you know. And the young people out there, you know when you come out of school and you start working, try to understand, work together with each other, you know? Don’t look at each other as, “He’s better. I’m not, I’m not going to, he’s better. I’m not going to…” You know? It’s not good. Be nice to each other. Say nice things to each other. At the same time inform patients what’s going on.
Rolando Mia: That is cool. I love that. I love the context around that. And I love the sentiment and the message about how this is affecting all of us at a global level and it’s not discriminating against anybody. Therefore, we need to come together. I think that’s one of the most powerful things. And it’s quite frankly a way we’re going to beat this.
If you were sum up and give a message to your colleagues out there, what’s the message that you’d like to get across to them?
COVID-19 Affects Everyone
Dr. Pavel Krastev: Well, first, the first step I think is we all have to realize that this affects all of us. We all have to realize that the anxiety level and the stress that we all experienced on daily basis is pretty much across the globe. So, if we try to stay in denial and just try to hide from this terrible monster that’s challenging all of us, we’re not going to get very far.
We have to battle it properly. We can’t do stupid things. You know we need to fight for peace, and all of our colleagues out there have to understand that we’re in this together. All right? And the stress level will decrease as we start to handle this disease better.
I’m not a mind reader. I can’t predict the future. I can’t tell you what will happen in two weeks. I can’t even tell you what my wife is going to make for dinner tonight. But coming together it’s going to make the pain less. And wait, look, Rolando we faced the HIV crisis, you know, twenty-five years ago. Certainly, that happened right when I came out of school.
That was a challenge in itself. It took a long time for, for the healthcare industry and the pharmaceutical industry to come up with the right drugs to treat the HIV infection. It was certainly a very scary process, a very scary disease for all of us. But we learned to cope with it, and we learned to protect ourselves from it as best as we can.
Now with COVID it’s a little bit different because it’s airborne. So that ends another effective here into the equation. But to the young guys out there, what can we do guys? We have to unite, and we have to just keep fighting this monster. You know? And be friends. Be close with your family members. Unite, network with your good friends, and we’ll get through it together. There’s what else can I say?
Rolando Mia: No, that’s perfect. I love that. Now you mentioned a couple of things. If people wanted to find your book, where could they find the book that you wrote with Dr. Bak?
Dr. Pavel Krastev: Alright. The book is on Kindle. It’s on Amazon print on demand, and it’s in Barnes and Nobles. When people look for it you have to put “The power of DR” and also write “The Modern Title of Nobility”. Okay? Because otherwise sometimes it doesn’t come up in the searches.
Learn More About Global Summit
Rolando Mia: And then you mentioned the Global Summit. If people wanted information about the Global Summit or they wanted to check out the, you know the programs or the education or the connection there, what would be the best way for people to find information about that?
Dr. Pavel Krastev: Well, okay. Let’s talk about that for a minute. So Global Summit was started seven or eight years ago by Dr. Kianor Shah. He’s a dentist. So right now, the program is called the Global Summit Institute, okay? So, if anybody wants information, if you just go to Facebook and you write Global Summits, it’ll pop up.
But under the Global Summit mothership, we have many platforms that, for example, the American Academy of Oral Surgery, we have the Doctor’s Comedy, okay? So, there’s… We have doctors uniting. I believe we have over 20 platforms that are under the mothership of Global Summit.
So, the mothership, we, like I said, this is a decentralized organization that has a board of regions. We have chairman, and it’s a very efficient organization in the sense that we bring some of the top speakers of the world to lecture to our colleagues, to tell them about their expertise in a particular area. And we basically want to bring dentistry back to the dentist.
We want to bring the autonomy that we as dentists and as healthcare providers, we had many years ago, then little by little insurance companies and this and that, they started controlling us. And we don’t like that too much.
We want to focus on getting our dignity back into the profession. And here’s why. As doctors we take the Hippocratic Oath, alright? When we take this oath, we have a relationship and a responsibility to treat our patients. Okay? When too many cooks start to interfere with this relationship and when insurance companies start dictating to the dentist, “Well, you can do this, but you can’t do this.”
Now the doctor is put in a situation where this Hippocratic Oath may perhaps be violated. Because the doctor wants to do what’s best for the patient, but the insurance company is saying, “No, you can’t do that.” And that becomes a problem.
So, I mean, I believe that we need to focus back on giving this special bond that exists between the doctor and the patient. We have to put it back in the hands of the doctor and the patient without allowing third parties to control what happens is a special relationship between a doctor and the patient. So Global Summits, myself, and the whole organization we really want to protect and unite and reestablish what we feel has been missing for quite a few years in instrument aspects.
Rolando Mia: That’s so cool. First of all, Dr. Pavel, I can’t tell you how much I appreciate you joining us and taking the time to speak to us. I love all of the things that you’re doing. I love the energy that you bring to the context and how you’re interacting. The message of connecting and making sure you’re connecting with the right people and ensuring that you’re maintaining that bond is very important.